Claremont Nursing and Rehabilitation — the county-owned long-term care facility — has obtained a five-out-of-five rating from the federal Centers for Medicare and Medicaid.
The county commissioners gathered at Claremont on Wednesday morning to congratulate staff on the top rating, which comes at a particularly critical time as Pennsylvania transitions toward a managed care model for Medicare and Medicaid.
“We know, in this regulatory environment, that it’s not easy to achieve this rating,” Commissioner Vince DiFilippo said.
After CMS revised its rating methods for 2015, Claremont dropped to a two-star rating, putting the publicly run facility on rocky ground.
But Commissioner Jim Hertzler said the county was always confident that the drop was an “aberration,” and that Claremont’s staff would bring it back up in short order.
“It’s a testament to your hard work and dedication to service our seniors in their time of need,” Hertzler said. “Unlike some for-profit nursing homes, our only bottom line here is the quality of care.”
“We know it’s tough, but we only see it at the 30,000-foot level,” Commissioner Gary Eichelberger said. “Until we’ve walked in your shoes, we can’t say we fully understand it, but we appreciate it.”
Claremont, as well as every other long-term care facility in the state, is grappling with Pennsylvania’s move to an expanded managed care system, which will roll out in 2018 for Pittsburgh and Philadelphia, and expand to the rest of the state in 2019.
The program will place seniors who are dual-eligible for Medicare and Medicaid into managed-care coverage provide by outside insurers, intended to incentivize better care and cost savings versus traditional fee-for-service coverage coming straight from the government.
“It’s unofficial, but most of the MCOs [managed-care organizations] want facilities to be at least three stars before they’ll work with them,” Claremont Administrator Bob Ritter said.
Ritter said the climb from two-star to five-star “means a lot” to the staff, as well as to Claremont’s future under the MCO program. Claremont is now one of two five-star-rated homes in Cumberland County.
It’s a positive step not just for seniors, but also for family members who trust Claremont with the care of their loved ones.
“Knowing the quality of care they’re getting here really helps for family ‘on the outside’ as well,” Ritter said.